Bottom Line:
Ganglioneuromas originate from neural crest cells and can affect any part of the sympathetic tissue from the skull base to the pelvis.However, ganglioneuroma occurring in the nerve root is extremely rare.We describe a 44-year-old man with ganglioneuroma involving the right fifth lumbar nerve root.

ABSTRACTGanglioneuroma is a rare, benign, slow-growing, well-differentiated tumor consisting ganglion cells and Schwann cells. Ganglioneuromas originate from neural crest cells and can affect any part of the sympathetic tissue from the skull base to the pelvis. However, ganglioneuroma occurring in the nerve root is extremely rare. We describe a 44-year-old man with ganglioneuroma involving the right fifth lumbar nerve root.

Mentions:
A 44-year-old male presented with low backache that aggravated on cough and strain. He also complained of numbness on both side saddle and toe and left calf muscle pain. On examination, root pain was along left L5 distribution with numbness in L5 dermatone. magnetic resonance imaging was suggestive of nerve root tumor [Figure 1]. Laminectomy in L5-S1, and excision if nerve root tumor after keeping perineural sheath intact. Tumor was excised end to end nerve sheath closed. On microscopic examination, there were clusters as well as scattered variably sized mature ganglion cells embedded in a stroma comprising of Schwann like cells with an elongated wavy serpentine nucleus [Figure 2]. The tumor was diagnosed as ganglioneuroma of L5 nerve root. Postoperatively, there was improvement with complete relief of pain and numbness around the saddle area and little toe in 7 days.

Mentions:
A 44-year-old male presented with low backache that aggravated on cough and strain. He also complained of numbness on both side saddle and toe and left calf muscle pain. On examination, root pain was along left L5 distribution with numbness in L5 dermatone. magnetic resonance imaging was suggestive of nerve root tumor [Figure 1]. Laminectomy in L5-S1, and excision if nerve root tumor after keeping perineural sheath intact. Tumor was excised end to end nerve sheath closed. On microscopic examination, there were clusters as well as scattered variably sized mature ganglion cells embedded in a stroma comprising of Schwann like cells with an elongated wavy serpentine nucleus [Figure 2]. The tumor was diagnosed as ganglioneuroma of L5 nerve root. Postoperatively, there was improvement with complete relief of pain and numbness around the saddle area and little toe in 7 days.

Bottom Line:
Ganglioneuromas originate from neural crest cells and can affect any part of the sympathetic tissue from the skull base to the pelvis.However, ganglioneuroma occurring in the nerve root is extremely rare.We describe a 44-year-old man with ganglioneuroma involving the right fifth lumbar nerve root.

ABSTRACTGanglioneuroma is a rare, benign, slow-growing, well-differentiated tumor consisting ganglion cells and Schwann cells. Ganglioneuromas originate from neural crest cells and can affect any part of the sympathetic tissue from the skull base to the pelvis. However, ganglioneuroma occurring in the nerve root is extremely rare. We describe a 44-year-old man with ganglioneuroma involving the right fifth lumbar nerve root.